CPT 99447E&M

Ntrprof ph1/ntrnet/ehr 11-20

CPT 99447 covers when a doctor or other qualified healthcare professional spends 11-20 minutes consulting with another doctor about your care through phone, internet, or electronic health records. This is interprofessional communication that happens without you being present.

Showing rates for

National Average

Base Medicare rate

$34.61

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

0.7

PE RVU (NF)

0.31

MP RVU

0.06

Total RVU

1.07

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Document exact start and stop times of consultation to prove the 11-20 minute time requirement
Impact: Missing time documentation causes up to 40% denial rate for these codes; adds $13.84 per claim saved
Ensure written or verbal report is documented in the medical record or transmitted to the requesting provider within 48 hours
Impact: Required element for billing; failure to document report results in denial of full $34.61
Bill only by the consultant who provides the professional opinion, not the requesting provider
Impact: Billing by wrong party results in 100% denial; clarify consultant vs requester role before submission
Do not bill 99447 for consultations occurring within 14 days of a previous E&M service you provided to the same patient
Impact: Considered bundled follow-up; bundling violation risks $34.61 recoupment plus potential audit
Verify that the patient has consented to the interprofessional consultation and is aware specialist input is being sought
Impact: Some payers require documented patient consent; missing consent may delay payment by 30-45 days
Use 99447 only for medical consultative services, not care coordination or administrative discussions
Impact: Administrative discussions are non-billable; clinical judgment documentation prevents downcoding or denial

Common denials

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Frequently asked questions

What is CPT code 99447 used for?

CPT 99447 is used for interprofessional telephone, internet, or electronic health record consultations between healthcare providers that take 11-20 minutes. The consulting provider reviews patient information, discusses the case with the requesting provider, and provides a written or verbal report with recommendations.

How much does Medicare pay for CPT 99447 in 2025?

Medicare pays $34.61 for CPT 99447 in 2025 (national average for both facility and non-facility settings). The code has 1.07 total RVUs (0.7 work RVU, 0.31 practice expense RVU, 0.06 malpractice RVU) multiplied by the 2025 conversion factor of 32.3465.

Can nurse practitioners bill CPT 99447?

Yes, nurse practitioners and physician assistants can bill CPT 99447 if they are acting as the consultant providing interprofessional assessment and recommendations to another provider. They must be considered qualified healthcare professionals (QHPs) and meet all documentation requirements including time and report transmission.

What is the difference between CPT 99447 and 99448?

The only difference is time: CPT 99447 covers 11-20 minutes of interprofessional consultation time, while CPT 99448 covers 21-30 minutes. Both require the same type of service (telephone/internet/EHR consultation between providers with written report), just different time thresholds.

Do I need patient consent to bill CPT 99447?

While CPT guidelines don't explicitly mandate patient consent, many payers and compliance programs recommend documenting that the patient is aware of and consents to the interprofessional consultation. Check individual payer policies, as some may require documented consent for reimbursement.

Can I bill 99447 and an office visit on the same day?

Generally no. If you perform a face-to-face E&M service with the patient on the same day, the interprofessional consultation is typically considered part of that service. However, if you're the consultant and never see the patient, you bill 99447 while the requesting provider bills their separate patient encounter.

How do I document time for CPT code 99447?

Document the exact start and stop times of your consultation activity, including time reviewing records, conducting the discussion with the requesting provider, and preparing the written report. The total time must be 11-20 minutes. Use timestamps, phone logs, or EHR time-tracking features as evidence.